NEW MEXICO’S OPEN ENROLLMENT
WHAT YOU NEED TO KNOW
Open enrollment for the New Mexico health care marketplace, BeWellNM, is about to get underway Friday, and it is critical for enrollees or potential enrollees to begin their applications as soon as possible.
“I always express with a sense of urgency the 45-day period for New Mexicans to re-establish benefits or elect coverage for the first time,” BeWellNM spokeswoman Maureen Manring told the Journal. Don’t put it off. Missing the Dec. 15 deadline could mean missing out on the chance to get insurance for all of next year unless qualifying for a special waiver because of a change in status, she said.
The first step is to go online and visit bewellnm.com, which provides a wealth of information including how much of a tax credit you might qualify for.
For new enrollees, the process can take as little as about 35 to 40 minutes depending on factors like number of medications, how many people in the family and medical needs.
Premium tax credit
One of the primary issues new enrollees need to decide is how much of the advance premium tax credit will be used to support premium payments, Manring said.
“(We) can help you look at your income — what you project for an income in the next calendar year for the household — and figure out how much of a tax credit based on income you project and the household size, you would be entitled to. Then they can help you decide if you want to use that tax credit in advance or wait until the end of the year.
“We are their resource to get them in touch with people or provide other guidance or direction as needed,” Manring said. “We have the ability to walk them through the quotes and give them a general idea of what they’re looking at in terms of premium cost.”
Applicants encountering any problem understanding information on the website or navigating the site can call the toll-free public assistance line at 833-862-3935.
The providers
Blue Cross/Blue Shield, New Mexico Health Connection, Molina Health Care and True Health New Mexico are the four carriers that serve BeWellNM and each has its strengths.
Each must provide at least the basic 10 essential health benefits:
■ Ambulatory patient services;
■ Emergency services;
■ Hospitalization;
■ Maternity and newborn care;
■ Mental health and substance use disorder services, including behavioral health treatment;
■ Prescription drugs;
■ Rehabilitative and habilitative services and devices;
■ Laboratory services;
■ Preventive and wellness services and chronic disease management;
Pediatric services,
■ including oral and vision care.
Sorting through the offerings from the four providers and helping applicants decide which provides the best plan for each individual is also an important role of BeWellNM, Manring said.
“What are options, what does the premium look like in their community and give them resources if they want to sit down with somebody to do an application. These are very important decisions for people to make. We want them to reach out to people in their local New Mexico community for support.”
Plan comparison tools
A key component of the website is a consumer checkbook tool that acts as a consumer benefits and cost comparison.
“It allows consumers to plug in their medical circumstances, prescriptions, income and it acts as a decision making tool,” Manring said. “It can give you the general quotes and a general idea of what the premiums are going to be and what the premium assistance or tax credit is going to be. It gives you a complete comparison.”
In addition, there are 27 free, public seminars that will be held in all corners of the state where experts will be on hand, and computers will be available, so enrollees can complete the process quickly and properly.
Go to bewellnm.com for a list of events near you, question and answer through email and also a “chat now” online function.
All 33 counties in the state are covered under the health marketplace and there are experts who offer free advice available in many of the communities across the state.
Re-enrolling easy
About 47,000 New Mexico residents are currently enrolled in health coverage through the marketplace, and re-enrolling is a relatively easy process because most of the information is already in the system.
“The distinction on that is if you are re-enrolling for the next year the application process is much shorter, briefer and doesn’t take as much information or time.
“A lot of the demographic information is already in the system so it’s more of an update. If you used a certified enrollment assister, insurance agent or broker/enrollment counselor, you can go back to them and they will help facilitate the re-enrollment process,” she said.
One last thing to be aware of is that deadline day, Dec. 15, falls on a Sunday, so don’t wait until the last minute to start the process.
“It’s very important to not miss the deadline,” Manring said.